BY CINDY SANDERS

Eddie George (left), pictured with Susan Cooper, RN, director of the Health Care Safety Net, and Governor Phil Bredesen, is the GetFit Tennessee Chairman.

Hillary Clinton once famously said, "It takes a village."

In Tennessee, however, Gov. Phil Bredesen knows that sometimes what you really need is a team.

Concerned about the state's consistently poor showing on national health rankings — many of which have direct ties to lifestyle choices — Bredesen recently announced several new initiatives to turn the tide on type 2 diabetes and get the state moving.

Tennessee has ranked near the bottom when it comes to physical activity and near the top for diabetes prevalence and death rates. Add to the mix the statistic that nearly 60 percent of the state's adult residents are overweight or obese, and a negative trend begins to emerge.

The governor said the genesis of ProjectDiabetes and GetFit Tennessee and the expansion of the Coordinated School Health program really stemmed from the research that went into TennCare reforms.

"We realized that while we had a very comprehensive health insurance program, we had not, in fact, moved any of these overall indicators of health," he said. "We've got to move away from constantly fighting to find another dollar to care for sickness and start putting some investment into keeping people healthy … and that's what this is all about."

More than $20 million in state money and federal grants is now being channeled towards this new proactive approach. To launch the initiatives, the governor has put together a multifaceted team with unique expertise.

Susan Cooper, RN, director of the Healthcare Safety Net and point person for ProjectDiabetes and GetFit Tennessee, said that by taking a targeted approach, the hope is that Tennessee will be able to modify some of the behaviors that contribute significantly to diabetes and other illnesses.

Cooper said nationally there are 20.8 million people who have diabetes and about 54 million with pre-diabetes. In Tennessee, she said the 2005 data indicates that about 9 percent of the state population, which is roughly 400,000 people, have been diagnosed with diabetes, the state's sixth leading cause of death. Additionally, Cooper said the prevalence rate of obesity has more than doubled in Tennessee in the past 15 years and tripled in adolescents over two decades.

"This is the first generation in history who are predicted not to live as long as their parents, and that is unacceptable," she stated.

While the news isn't very good for the state, Cooper said it does lend itself to a targeted approach. "When you drill down, it really comes down to two things … changes in diet and increasing physical activity."

She stressed the goal is to encourage modest changes. Evidence-based medicine suggests losing just 5 percent of body fat and increasing physical activity by 30 minutes a day can be enough to make a difference.

Cooper said to begin the process the state Legislature approved language that creates the Tennessee Center for Diabetes Prevention (more commonly referred to as ProjectDiabetes). The board will consist of five appointees from the governor and one each from the speakers of the House and Senate. Ex officio members will include the commissioners of health, education and agriculture along with the chairs of the Senate General Welfare Committee and the House Health Committee plus chairs of both the Senate and House education committees.

Cooper said a multifaceted problem takes a multidisciplinary approach with team members bringing specific expertise to the table. The center is authorized to provide grants that focus on prevention and/or treatment of type 2 diabetes and to provide funding to provider groups for evidence-based programs focusing on obesity, diabetes and pre-diabetes.

"It really is going to take an army to do something about this," Cooper stated.

Additionally, the governor said he hopes to bring community partners and corporate leaders into the mix. The plan also calls for regional strategies and flexibility for different areas of the state to find what works best for their population.

"I really believe one size doesn't fit all in Tennessee," said Bredesen. "What it might take to change behavior in a rural area may not be the same thing it takes to change behaviors in an inner city urban area or in a suburban area."

To tailor the approach to the school system level, $15 million has been devoted to expanding the existing Coordinated School Health program. Piloted in 10 counties, the budget allotment should expand the initiative to most every school system in the state. The broad-based programming might include expanded PE classes, additional nutrition and health modules or turning the cafeteria into a hands-on classroom.

While much of the activity is focused on instilling better nutritional habits, the GetFit Tennessee component hopes to get everyone off the couch and moving. Cooper noted that when asked, nine out of 10 parents think their children are physically fit, but when the measurements are taken, the figures are more like one in three.

To motivate children and their parents, Governor Bredesen handed the ball to former Tennessee Titan and Heisman Trophy winner Eddie George. Who better, the governor reasoned, to ask to take the message of physical fitness and run with it than an All Pro running back?

"He certainly is a hero to a lot of kids," the governor said, and added with a chuckle that people are much more likely to take fitness tips from an athlete rather than a politician.

"We want to bring the fun back into this," Cooper said. "What Eddie George really brings to the table is he is truly committed to working with children and committed to help them understand the benefits of a healthy lifestyle."

All the key team members realize that change won't come overnight, but Cooper said she sees tremendous support across both political parties and determination throughout communities statewide.

"There are a lot of pieces to this jigsaw puzzle and many are beginning to fall in place, but we've got to make sure we cover the gaps," Cooper said.

She concluded that the governor has "invited all Tennesseans to come to the table to join his Team Tennessee, and that's exciting. We've got lots of smart people in Tennessee, and we can make substantial changes. We just need to come together and do it."




November 2006